Evidence map›Paper›PMID 41462294›Full record

ArticleTrials2025

Memantine and graded motor imagery for complex regional pain syndrome (MEMOIR): study protocol and statistical analysis plan for a decentralised, 2 × 2 factorial randomised trial.

Michael C Ferraro, Yannick L Gilanyi, Eric J Visser, Andrew J McLachlan, G Lorimer Moseley, Benedict M Wand, Neil E O'Connell, Hopin Lee, Martin Lotze, Jody Church and 6 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Michael C FerraroSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia. m.ferraro@neura.edu.ORCID http://orcid.org/0000-0003-0563-1832
Yannick L GilanyiSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
Eric J VisserFaculty of Medicine, Nursing and Midwifery and Health Sciences, The University of Notre Dame Australia, Fremantle, Australia.
Andrew J McLachlanSydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
G Lorimer MoseleyIIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia.
Benedict M WandFaculty of Medicine, Nursing and Midwifery and Health Sciences, The University of Notre Dame Australia, Fremantle, Australia.
Neil E O'ConnellDepartment of Health Sciences, Centre for Health and Wellbeing Across the Lifecourse, Brunel University of London, Uxbridge, UK.
Hopin LeeExeter Medical School, University of Exeter, Exeter, UK.
Martin LotzeFunctional Imaging Unit, Center for Diagnostic Radiology, University of Greifswald, Greifswald, Germany.
Jody ChurchCentre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia.
Stephen GoodallCentre for Health Economics Research and Evaluation, Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia.
Robert D HerbertGeebung Statistical Consulting, Blackheath, NSW, Australia.
Sarah E LambExeter Medical School, University of Exeter, Exeter, UK.
Sylvia M GustinCentre for Pain IMPACT, Neuroscience Research Australia, Randwick, NSW, Australia.
Aidan G CashinSchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
James H McAuleySchool of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.

Funding

National Health and Medical Research Council APP1163149
6 · The paper itself

Abstract

backgroundComplex regional pain syndrome (CRPS) is a rare chronic pain condition characterised by severe pain, sensory, motor, autonomic, and trophic abnormalities. Effective treatment options are limited, and international guidelines rely on low-quality evidence and consensus. Two interventions-memantine, an N-methyl-D-aspartate receptor antagonist, and graded motor imagery, a rehabilitation approach targeting sensorimotor processing-have shown promise in pilot studies but lack definitive evaluation in large-scale trials. MEMOIR aims to evaluate the benefits and harms of memantine and graded motor imagery for CRPS.

methodsMEMOIR is a fully decentralised, 2 × 2 factorial, randomised trial comparing memantine with placebo and graded motor imagery with no graded motor imagery in adults with CRPS. A total of 204 participants with CRPS of 6 months to 5 years duration will be randomised to one of four groups: (i) memantine and graded motor imagery, (ii) memantine only, (iii) placebo and graded motor imagery, or (iv) placebo only. Memantine will be administered at 40 mg/day (or maximum tolerated dose); graded motor imagery will comprise seven 1-h sessions delivered via telehealth. The treatment period is 16 weeks. The dual primary outcomes are pain intensity (11-point numeric rating scale) and PROMIS pain interference assessed at 16 weeks. Secondary outcomes include physical function, fatigue, cognitive function, depressive symptoms, self-efficacy, health-related quality of life, CRPS severity, healthcare use, and adverse events. The follow-up period is 52 weeks. The estimands of interest are the mean effect of memantine compared to placebo and the mean effect of graded motor imagery compared to no graded motor imagery on all outcomes. All analyses will follow the intention-to-treat principle. DISCUSSION: MEMOIR will be the largest investigator-initiated CRPS trial to date. The 2 × 2 factorial design and decentralised delivery aim to maximise efficiency, accessibility, and equity. If effective, memantine and graded motor imagery represent scalable, low-cost treatments that can be given in clinics or at home, with the potential to transform CRPS management.

trial registrationAustralian New Zealand Clinical Trials Registry ( ACTRN12621000175875 ). Registered on 12 February 2021.

Indexed as

Complex Regional Pain SyndromesExcitatory Amino Acid AntagonistsImagery, PsychotherapyMemantineAdultData Interpretation, StatisticalFemaleHumansMalePain MeasurementQuality of LifeRandomized Controlled Trials as TopicReceptors, N-Methyl-D-AspartateResearch DesignTime FactorsTreatment OutcomeExcitatory Amino Acid AntagonistsMemantineReceptors, N-Methyl-D-AspartateChronic painComplex regional pain syndromeFactorialGraded motor imageryMemantine

Identifiers

PMID41462294
PMCPMC12874714

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.